胃癌中CD44v6和nm23基因蛋白的表达及其临床意义

目的：探讨CD44v6和nm23的表达与胃癌侵袭转移的关系，了解胃癌中CD44v6蛋白表达与nm23蛋白表达的相关性。方法：采用免疫组化S－P法检测CD44v6及nm23在胃癌中的表达情况。结果：CD44v6阳性表达率在进展期胃癌显著高于早期胃癌（P＜0．05），伴淋巴结转移组和肝转移组明显高于无转移组（P＜0．05），CD44v6表达与胃癌的侵袭转移倾向呈正相关（P＜0．05）;nm23阳性表达率在进展期胃癌明显低于早期胃癌（P＜0．05），伴淋巴结转移组和肝转移组显著低于无转移组，nm23蛋白表达与胃癌的侵袭转移倾向呈负相关（P＜0．05）。胃癌中CD44v6及nm23蛋白表达之间呈明显负相关关系（P＜0．01）。结论：胃癌组织中CD44v6和nm23蛋白的检测可用于胃癌转移的预测、恶性程度的评估和预后的判断。     

黏附分子表达与老年结肠癌浸润转移的关系

目的探讨黏附分子唾液酸化路易斯-X（sialyl Lewis-X，SLeX）、CD44v6和E-上皮钙黏附素（E-cadherin，ED）表达与老年结肠癌浸润转移的关系。方法应用免疫组织化学技术，检测80例老年结肠癌组织中SLeX、CD44v6和ED蛋白表达。结果SLeX、CD44v6和ED阳性表达率分别为77．5％（62／80），70．0％（56／80）和52．5％（42／80）。SLeX、CD44v6高表达及ED低表达与老年结肠癌Dukes分期、浆膜浸润、淋巴结转移、肝脏转移和和患者预后均呈正相关（P〈0．05）。结论SLeX、CD44v6和ED表达与老年结肠癌浸润转移和患者生存期密切相关。检测SLeX、CD44v6和ED蛋白表达可作为判断老年结肠癌预后的客观指标。     

CD44-v6、整合素β1对外科根治性胰腺癌患者预后的影响

【目的】探讨细胞黏附分子CD44变异型外显子‐6（CD44‐v6）、整合素β1与根治性胰腺癌患者预后的关系。【方法】对在本院接受治疗的85例胰腺癌患者,比较CD44‐v6、整合素β1在不同临床病理特征的胰腺癌组织中的阳性表达率及其与肿瘤标志物癌胚抗原（CEA）、糖类抗原19‐9（CA19‐9）糖类抗原125（CA125）水平的相关性。【结果】死亡组患者CD44‐v6、整合素β1阳性表达率和CEA、CA19‐9,CA125水平明显高于生存组,且差异具有显著性（ P ＜00．5）;年龄较大、分化程度低、有远处转移、侵犯血管的胰腺癌患者CD44‐v6和整合素β1阳性表达率较高（ P ＜00．5）,而不同性别、肿瘤直径和是否有淋巴结侵犯的患者术后CD44‐v6,整合素β1阳性表达率无明显差异（ P ＞0．05）;胰腺癌患者 CD44‐v6、整合素β1阳性表达率与 CA19‐9、CA125、CEA呈显著正相关（ P ＜00．5）。【结论】CD44‐v6、整合素β1在预后较差的胰腺癌患者中高表达,且与肿瘤标志物水平正相关,可作为判断患者预后的重要指标。     

CD44拼接变异体V6与上皮钙粘附素在胰腺癌中的表达及意义

目的探讨CD44拼接变异体V6（CD44 Splicevarint V6，CD44V6）和上皮钙粘附素（E-Cadherin，E-CD）在胰腺癌中表达及与胰腺癌浸润、转移的关系，评价CD44V6和E-CD在胰腺癌浸润转移中的作用。方法采用SP免疫组化染色方法，检测43例胰腺癌组织中CD44V6和E-CD的表达情况。结果正常胰腺导管上皮细胞CD44V6呈阴性表达，胰腺癌组织中CD44V6阳性表达率达58．1％（25／43），CD44V6阳性表达与胰腺癌浸润深度、淋巴结转移情况密切相关（P〈0．05），与胰腺癌组织分化程度无关（P〉0．05）。正常胰腺导管上皮细胞E-CD呈强阳性表达，60．5％（26／43）的胰腺癌组织中E-CD呈异常表达，E-CD的异常表达与胰腺癌组织分化程度、浸润程度、淋巴结转移情况关系密切（P〈0．01）。CD44V6和E-CD在胰腺癌中的表达无明显相关性（P〉0．05）。结论CD44V6阳性表达和E-CD异常表达与胰腺癌浸润、转移关系密切，检测CD44V6和E-CD表达有助于对胰腺癌浸润转移潜能的判断，二者可以作为胰腺癌浸润转移的生物学指标。     

CD44s和CD44v6在大肠病变中表达及其预后的意义

目的：明确CD44s和CD44v6在大肠病变中表达的临床意义。方法：应用免疫组织化学SP法检测85例大肠癌和28例大肠腺瘤及36例癌旁正常肠黏膜中CD44s和CD44v6蛋白表达与分布和临床意义。结果：CD44s和CD44v6在大肠腺癌中表达率分别为67．1％和92．9％，在伴有不典型增生的大肠腺瘤组织中分别为66．7％和88．9％，两者与癌旁正常肠黏膜组织相比，有显著差异（P〈0．01）。CD44s和CD44v6蛋白阳性过度表达与大肠癌的临床Duke’s分期密切相关（P〈0．01），5a生存期不足5a组CD44v6阳性率明显增高（P〈0．05）但CD44s和CD44v6蛋白阳性表达均与大肠腺癌分化程度、有无淋巴转移及远处转移不相关（P〈0．01）。结论：CD44s和CD44v6蛋白阳性表达对大肠癌早期诊断有一定意义，尤以CD44v6意义更大。而且，CD44v6对大肠癌癌患者估计预后有一定意义。     

上皮细胞钙黏附素在鼻咽癌中的表达

目的 探讨上皮细胞钙黏附素（E—CD）在鼻咽癌中的表达关系。方法 采用免疫组织化学方法对56例鼻咽癌活检病理标本的E—CD表达进行研究。结果 56例鼻咽癌中E—CD阳性表达15例,弱阳性表达16例,阴性表达25例：而20例正常鼻咽黏膜E—CD阳性表达18例,弱阳性表达2倒（P＜0．01）。中分化鳞状细胞癌阳性表达3／4,低分化鳞状细胞癌阳性表达12／47,未分化细胞癌均为阴性表达（P＜0．025）。结论鼻咽癌细胞E—CD表达改变与鼻咽癌细胞分化程度有关,失去E—CD阳性表达的肿瘤细胞,细胞问的黏附能力减低或丧失,是鼻咽癌易发生颈淋巴结转移的因素之一．     

CD44v6与血管内皮生长因子在子宫颈鳞癌中的表达及其意义

目的 探讨子宫颈鳞状上皮细胞癌CD44v6和血管内皮生长因子（VEGF）表达与肿瘤浸润和淋巴结转移的关系。方法 应用CD44v6和VEGF单克隆抗体，采用微波-LSAB免疫组化染色方法对50例宫颈鳞癌进行免疫组化染色，并取10例正常宫颈组织作对照。结果 有淋巴结转移宫颈鳞癌CD44v6、VEGF与无淋巴结转移组、正常对照组组间比较，均有非常显著的差异性（P〈0．01）；浸润癌CD44v6与原位癌、早期浸润癌比较，均有显著差异（P〈0．05）。结论 CD44v6和VEGF表达水平与宫颈鳞癌浸润转移密切相关，可作为预测宫颈鳞癌病人预后和转移的生物学指标。     

内镜超声结合E-钙粘素和CD44v6检查在食管癌诊断中的价值

目的　探讨术前内镜超声检查 (EUS)及E -钙粘素 (E -CD)、CD4 4v6表达在食管癌术前分期诊断中的价值。方法　对 5 8例食管鳞癌患者术后标本应用SP法检测E -CD和CD4 4v6的表达 ,对其中 30例食管鳞癌患者术前进行了EUS。结果　EUS诊断食管鳞癌术前TNM分期与术后病理分期对照 ,其T期总的准确率为 83% ,N期总的准确率为 77%。E -CD、CD4 4v6阳性表达率与食管鳞癌患者肿瘤细胞浸润深度、淋巴结转移显著有关 (P <0 .0 1) ,与食管癌患者临床分期有关 (P <13.0 5 )。但在食管鳞癌原发灶中E -CD和CD4 4v6表达无相关性 (P >0 .0 5 )。食管癌患者中UESTN分期与E -CD、CD4 4v6阳性表达率显著相关 (P<0 .0 1)。结论　E -CD和CD4 4v6均可反映食管癌生物学行为的指标 ,将两种细胞粘附分子的检测与EUS结合起来 ,能更准确地对食管癌患者进行TNM分期。     

上皮型钙黏附素和β-连环素表达水平与非小细胞肺癌侵袭、转移及预后的关系

目的 探讨上皮型钙黏附素和β-连环素在非小细胞肺癌（NSCLC）发生、发展和转移中所起的作用及其表达水平与预后的关系.方法 采用免疫组化（SABC）法、检测111例NSCLC和23例肺良性病变组织中上皮型钙黏附素和β-连环素的表达水平,分析其与肺癌病理生理特征及患者预后的关系.结果 肺癌组织中上皮型钙黏附素和β-连环素表达水平均显著低于癌旁肺组织和肺良性病变组织（P＜0.01）.上皮型钙黏附素和β-连环素在鳞癌中的表达水平均显著低于腺癌和腺鳞癌,在Ⅲ期肺癌中的表达水平显著低于Ⅰ和Ⅱ期肺癌（P＜0.01）,伴有淋巴结转移肺癌中上皮型钙黏附素和β-连环素的表达水平均显著低于不伴有淋巴结转移者（P＜0.01）.低分化肺癌中上皮型钙黏附素表达水平显著低于中-高分化肺癌（P＜0.05）;β-连环素在低分化肺癌和中-高分化肺癌中的表达水平无显著性差异（P＞0.05）;上皮型钙黏附素和β-连环素高表达组（表达水平≥50%）的5年生存率显著高于低表达组（表达水平＜50%）（P＜0.01）.结论 上皮型钙黏附素和β-连环素表达水平降低与NSCLC的发生、发展、转移有密切关系,检测上皮型钙黏附素和β-连环素在肺癌中表达水平对预测患者预后有重要意义.     

骨桥蛋白和CD44v6在大肠癌中的表达及其意义

【目的】探讨骨桥蛋白（OPN）和CD44拼接变异体6（CD44v6）在大肠癌中的表达及其与大肠癌临床病理特征的关系。【方法】采用免疫组化法检测43例大肠癌标本中OPN和CD44v6的阳性表达情况,分析其与大肠癌的临床病理特征的关系。【结果】有淋巴结转移的大肠癌组织中OPN、CD44v6表达阳性率均为86．7％（13／25）,无淋巴结转移者分别为50．0％（i4／28）、53．6％（15／28）,二者相比差异均有显著性（P〈0．05）;组织学分级为Ⅲ级的大肠癌组织中OPN、CD44v6的表达率均为85．7％（12／14）,组织学分级为Ⅰ～Ⅱ级的大肠癌组织中OPN、CD44v6的表达率分别为51．7％（15／29）、55．2％（16／29）,二者相比差异有显著性（P〈0．05）;CD44v6与OPN的表达呈正相关,相关系数：为0．446（P〈0．05）。【结论】OPN和CD44v6的表达可能与大肠癌的病理类型和组织学分级有关。     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Quality and suitability of antimicrobial discs: theoretical and practical sources of error and variability

ABSTRACT

Introduction: The use of antimicrobial discs remains one of the main methods for assessing antibiotic activity. Most discs are made to one of three main standards (FDA, WHO, DIN); these all describe an assay method for assessing the quality of discs using a linear method. Theory predicts a curved relationship, and this is backed up in many cases in practice. In such cases, the assays are potentially invalid. Other sources of uncertainty arising from the manufacturing processes employed are also discussed.

Areas covered: This includes error arising from applying FDA, WHO, and DIN standards, the manufacturing techniques employed, and variation in the materials used in production. The need for a specification that relates directly to the use of the discs is also discussed.

Expert opinion: Manufactured discs, some of which may be out of specification due to curvature and other sources of error, have been used to establish quality zone sizes. Quality zone sizes have then been used to measure the quality of discs. This circular quality system where there is no quantitative check is potentially unsafe. In the many decades of their use, there has been no comprehensive check on the quality of manufactured discs using quantitative, validated assays.